Have you ever wondered which muscles are involved in walking or running, or how great pitchers may throw a "perfect" pitch? Where do professional sports teams and coaches get the information they need to help their players improve their conditioning and performance, and keep injuries at bay? The answer is from a specialist in sports medicine. These may either be sports medicine physicians (who will treat a sprained ankle for example) or sports medicine researchers (who will be looking for answers in a lab), and may accordingly come from a variety of backgrounds--bioengineering, medicine, and physical therapy. But their common interest in sports science makes them members of one of the hottest fields in applied research today. The study of the mechanics of motion as it relates to sports injuries provides the expertise that keeps athletes, both professional and amateur, in the game.

The American Sports Medicine Institute (ASMI) located in Birmingham, Alabama, is unique in that it offers training to both those interested in a career in sports medicine research and in clinical practice. The students and research staff at ASMI are dedicated to its mission: to improve the understanding, prevention, and treatment of sports-related injuries through research and education.

Glenn Fleisig, who holds the position of Smith and Nephew Chair of Research at ASMI gave Science's Next Wave a behind-the-scenes look at how ASMI trains this nation's next generation of sports scientists, as well as insight into his own career path.

Field of Dreams

When Fleisig was a child growing up in Tappan, New York, he wanted to become a baseball player. Like many youngsters, he worked on his skills by playing baseball whenever possible. But by the time he reached high school at the Horace Mann School, he realized he may have to modify his plans. "I didn't make the varsity baseball team, but I was getting A's in math," he says. I knew I had to make a career change.

After high school, he attended the Massachusetts Institute of Technology as a mechanical engineering major. In 1983, during his senior year, he had numerous labs to choose from for his undergraduate project. But one of them was different. "Other labs were learning how to make engines or studying thermodynamics or fluid dynamics, but this lab was studying a golf swing and how people walked," Fleisig says. So even though this was the first time he was hearing the term "biomechanics," he decided to give it a try, and got hooked.

In 1984, while the summer Olympics were being held in Los Angeles, Fleisig traveled to the U.S. Olympic Training Center (USOTC) in Colorado Springs, Colorado, to do an internship. There he met Jim Andrews, an up-and-coming orthopedic surgeon with an interest and early success in treating injured baseball players. Andrews' dream was to start a foundation that would train the sports physicians and researchers of tomorrow, so he and Fleisig spent many hours discussing the possibilities and how it would benefit sports medicine in general.

After completing an exciting and rewarding stint at the USOTC, Fleisig looked for a job in sports biomechanics, then realized there were very few jobs in the field. So instead, he worked as a mechanical engineer at Kearfott Guidance & Navigation Corp. and eventually went to graduate school to pursue that line of work at Washington University in St. Louis. He was actively pursuing his master's degree in mechanical engineering when, in 1986, he received a call from his old acquaintance, Jim Andrews. Fleisig explains: "Out of the blue Dr. Andrews called me up and asked me if I was still interested in starting [what would become] ASMI. I said, yes! Maybe your plan is to go through school and then get the right job, but the right job knocked on the door a little earlier, so I took the chance."

Fleisig moved to Alabama to help found ASMI. While ASMI was finding its footing, he took evening classes at the University of Alabama at Birmingham (UAB) and transferred class credits back to Washington University so that he could finish his master's degree. Since UAB was basically across the street from ASMI, he was even able to pursue a Ph.D. there.

Student Research at ASMI

ASMI researchers are involved in different fields such as biomechanics (motion analysis, which includes cadaver research, namely, the use of human limbs to analyze anatomy, motion, and the strength of muscles, tendons, ligaments, and bones) and clinical research (tracking patients to see how successful they are returning to sport after treatment with surgery or physical therapy). Fleisig supervises various projects himself and welcomes students throughout the year. "During the year, we have up to two students [at one time], but during the summer it's typically two to 10," Fleisig explains (see box below). "We try to match students' interests and talents with what we have here at ASMI. We hope to identify a project they can work on before they arrive, so it's not a waste of the students' time or our time." This summer, ASMI accepted two students out of 15 applicants.

The Student Researcher Program

The Student Researcher Program allows postdoctoral, graduate, and undergraduate students to participate in research at ASMI. Students are accepted year round and may receive thesis credit, course credit, or financial support from their institution. Those interested in a career in sports medicine research should apply.

ASMI participants range from postdoctoral fellows to high school students. Typically, undergraduates come in the summer and graduate students come during the rest of the year for extended stays with the purpose of conducting thesis research. ASMI research participants don't get paid by ASMI, but what they leave with is invaluable. "Some receive funds through their university or get school credits. We don't charge them and we don't pay them. They come for experience," Fleisig says.

The typical day of ASMI students varies, depending on their abilities. According to Fleisig, "premeds tend to help more with the clinical studies such as tracking patients, doing follow-up surveys, entering data into spreadsheets, and summarizing results about how many patients returned to sport, etc. Engineering students tend to help with the motion analysis studies; however, both types would help with cadaver studies."

Mark Pantoni, a premed senior at the University of Florida, Gainesville, is currently working under the clinical research coordinator, Jeremy Loftice and helps out with baseball pitching evaluations. "I love it," he says. "I've always had an interest in sports medicine, especially baseball. I get to see the biomechanics of pitching and learn the critical aspects of how to treat and prevent injury. I plan to attend medical school and specialize in sports medicine. My long-term goal is to become a professional sports team physician."

As for Rajiv Ranganathan, a master's student in kinesiology at the University of Illinois, Urbana-Champagne, he is working with Fleisig. He, too, wants to become a pitching expert. "I'm interested in the biomechanics of baseball pitching and throwing in general," he explains. "I have an engineering background, so I'd like to know what kind of forces and torques are generated at the elbow and shoulder. This has been a great experience so far. My future goal is to do my Ph.D. in biomechanics and go on from there."

The Future of Sports Science Research

At present, most sports science research is being applied at the top level to professional and Olympic athletes. Sports scientists advise top coaches on the mechanics of a gymnast tumbling, a pitcher pitching, or a quarterback throwing a football. But Fleisig sees a change already occurring. "What we do will be more accepted and will affect the general population of athletes," he says. While college athletics already have access to sports medicine to some extent, Fleisig predicts that the biggest benefit will be seen at the high school level. "For example, a high school coach who has limited information available on proper mechanics will be able to access this information either through computers or videos," he explains. "The ongoing success of our field and the decrease in the cost of equipment will drive this new wave in sports medicine."

Fleisig also predicts a change in the general perception of sports research. "Most people's concept of sports medicine is, if you have an injury, let's fix it," he explains. "But there is a gradual shift from treatment to prevention. For instance, should young children throw curve balls, or how many pitches should they throw, to what kind of nutrition should they have or which exercises should they be doing? The mindset is changing from physical therapy and surgery to coaching mechanics, strength, conditioning, and nutrition." This new way of thinking will benefit all who participate in and enjoy the competition of sports.